Anesthesia Risks of Tattoos and Pierced Tongues More Than Skin Deep

Two popular forms of self-expression today are tattoos and piercings. But unlike other fashion statements, body ornamentation such as lower-back tattoos and pierced tongues may carry health risks should the wearer need anesthesia care, according to the American Association of Nurse Anesthetists (AANA).

A tattoo is a permanent mark or design made on the body with pigment injected into the dermal layer of the skin through ruptures in the skin’s top layer. A small needle punctures the skin repeatedly—an action resembling that of a sewing machine—and inserts tiny ink droplets with each puncture. Theoretically, inserting a needle through the pigment of a tattoo may result in a tissue core that contains pigment, leading to possible neurological complications later on.

The AANA is not opposed to tattoos and respects peoples’ rights to adorn their body however they please. However, since the jury is still out on whether injecting a needle through a tattoo poses a significant health risk, the AANA cautions anyone interested in obtaining a tattoo to give strong consideration to where it is placed on their body.

For example, a popular tattoo location among young women is the lower back. These women don’t necessarily consider that someday they might need an epidural during labor and delivery, and may encounter subsequent problems if the needle has to pass through a tattoo. At this point, the risk of infection is still unknown.

A study conducted by the Canadian Journal of Anesthesia to test the ramifications of women receiving epidural anesthesia in a tattooed area encountered a patient whose tattoo covered her entire back, making it impossible for the anesthesia provider to locate a lumbar interspace that did not have tattoo pigment in the overlying skin. Aside from the difficulty in locating a suitable area to insert the epidural, the woman received the epidural without incident. Other studies conducted on this matter have shown no adverse effects on the patient or anesthesia process. However, possible long-term implications from depositing a pigmented tissue core into these areas are unknown.

If a patient who is scheduled to have surgery has a pierced tongue, then the tongue ring is removed prior to the procedure. That’s simple enough. The potential for trouble arises in emergency situations when the patient needs to be intubated—that is, have a breathing tube inserted down his or her throat—to receive urgent care.

A pierced tongue isn’t typically the first thing on the anesthesia provider’s mind while they’re preparing the patient for surgical or some other emergency care. The instrument used to insert the breathing tube may catch on the tongue ring, tearing the tongue or knocking the ring down the patient’s throat.

It’s unlikely that people who get their tongue pierced consider this sort of associated health risk. But as the popularity of this type of piercing grows, people need to be aware of all possible ramifications.

Public Service Announcement: Tattoos and Anesthesia (:30)

Text for Public Announcement:

Here's something to "ink" about. More and more people are getting tattoos. But unlike other fashion statements, body ornamentation may carry health risks. According to the American Association of Nurse Anesthetists, injecting an anesthetic through a tattoo may be risky. For example, a popular tattoo location among young women is the lower back. It is not known whether this could pose a problem if you later need an epidural during childbirth. Since the risk of infection is still unknown, use caution when choosing a location for your tattoo.

Public Service Announcement: Health Alert (:30)

Text for Public Service Announcement:

Unexpected health risks may be the result of certain types of body ornamentation. Tongue piercings are increasingly popular, but they could pose a problem should the wearer need emergency anesthesia care, according to the American Association of Nurse Anesthetists. The instrument used to insert a breathing tube in an emergency may catch on the tongue ring, tearing the tongue or knocking the ring down the patient's throat. As the popularity of this type of piercing grows, people need to be aware of all possible consequences.